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Cardiovasc Interv Ther. 2013 Jul;28(3):272-8. doi: 10.1007/s12928-012-0155-7. Epub 2013 Jan 1.

A case report of very late stent thrombosis with peri-stent coronary artery aneurysm and stent-related coronary vasospasm.

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1
Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Nasushiobara, Japan. mtakeda@iuhw.ac.jp

Abstract

We describe a 42-year-old man with very late stent thrombosis (VLST) 35 months after implantation of a sirolimus-eluting stent (SES). Three months after the VLST episode, a follow-up angiography showed a formation of peri-stent coronary artery aneurysm. Sixty-five months after SES implantation, the patient suffered an out-of-hospital cardiac arrest. We performed spasm provocation test using acetylcholine to evaluate coronary vasomotor response and the coronary segments adjacent to the SES showed significant vasoconstriction. Intracoronary pretreatment of Rho-kinase inhibitor, fasudil, markedly attenuated acetylcholine-induced vasoconstriction. This report documents a unique case suffering from multiple fatal complications after SES implantation.

PMID:
23277349
DOI:
10.1007/s12928-012-0155-7
[Indexed for MEDLINE]
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